Saturday, March 30, 2013

Up and Coming

Hello Redwood's Fans!

I usually post the Up and Coming segments on Sunday's but in light of the forthcoming Easter holiday I've decided to post it on Saturday.

I hope you have a wonderful celebration with family. One of my favorite posts I've ever written was about Easter and what it means to me. Hopefully it can bless you as you consider the true meaning of the day.

For you this week:

I'm continuing with author questions!

Monday: Car accident with multiple victims.

Wednesday: Homemade IV solutions. Is it possible?

Friday: Death by Food Allergy.

Have a GREAT Easter.

Friday, March 29, 2013

Author Question: Condition of Body in Two Views

Angela Asks:

I am an Australian writer of crime fiction novels set in SE Asia, specifically Thailand. You can read more about me and my books here:

In my current novel, The Dying Beach, a body washes up in the shallows of a cave by a beach. I've done a bit of research on forensics and how you distinguish drowning from accidental death. What I hope you can help me with is the following.

The body is that of a young Thai woman. Would the skin of the corpse whiten if it had been in the water for say, 12 hours, or would the skin still appear olive?

The body is found by a war surgeon on vacation, floating face down. When the body is rolled over, would you expect to find the eyes open? Would they be clear or cloudy?

Is there anything else I should know about a corpse found in this state? 

FYI the corpse is found in shallow, tepid water.

Any advice you can give would be much appreciated.

Jordyn Says

I actually ran this question by two sources: a physician coworker and a forensic investigator. Here are their responses.


As far as the skin pigmentation-- she said a person will retain the pigment. They might look gray but won't be "whiter". And you'll have to consider how blood settles when someone dies.
As far as the eyes being open or closed-- she thinks partly open because it takes muscles to keep your eyes closed and if you're dead-- these aren't functioning anymore.
As far as the eyes looking cloudy-- I know when I've taken care of patients that have died, the color in their irises-- this is the colored part of your eye-- definitely look like the color leaches out. Almost looking gray. So, no clear answer here-- you could probably have a little creative license.


1)  A person's skin pigmentation would not change unless the person has been dead for at least several weeks. Then the body would turn green and eventually black due to the decomposition. But this would take weeks into months depending on the environment the body is in (hot, cold, dry, humid, etc.).

2) When the body is rolled over the eyes may or may not be closed. There is no rhyme or reason for it. I would expect the eyes to be clear. Typically the eyes would become cloudy after the decedent has been dead for at least several days/weeks.

3) There really is not a whole lot more information. The hands would show sign of wrinkling, referred to as "washer woman hands". This can make fingerprinting for identification difficult. Sometimes marine life will start to eat the body. This typically occurs about the face, eyes, and genitals. This of course would typically not occur within 12 hours of death. Another thing is when a body has been in the water for day(s) and is removed, decomposition will tend to accelerate. The bacteria has had no oxygen source as the body has been in water. Once the body is removed and the bacteria has a oxygen source, they really go to work to make up for lost time.

Wednesday, March 27, 2013

Author Question: Consent Issues Peds ER

Carol Asks:


Hero's daughter is spending the night at the heroine's house b/c he has to work. They think she has the flu but is appendicitis and is gonna burst [based on a friend's kid's experience ;)]. Heroine wakes up to hear her crying in the middle of the night. Goes to check on her and gets her roomie who is a licensed [but not practicing] paramedic. Says we gotta get straight to the hospital but hero isn't answering phone.

So, they get there, but dad's nowhere to be found. Heroine knows daughter's name/birthday but that's it [not even an address].
1. Will they still try to find a patient in the computer based on the info they have [patient's name, birthday, town, dad's name etc]?
Jordyn: How old is the child? A first or second grader should know their address so they would look up her name and birthday and try and match the address. If not, they’ll just create a new chart. It’s possible to merge electronic records at a later time. Do they not even have a phone number to reach him? That would be pretty odd.
2a. How much credence will they give to the medic since it's not someone they know? He's gonna rattle off information [HR, BP, temp, etc] and don't they have some sort of ID card he could use to back up his claim that he knows what he's talking about?
Jordyn: It’s anecdotal. We’d probably be most interested in the temperature. She’ll get her vital signs taken at the time and it might be curious if they are markedly different than what the paramedic got. But, we won’t ask for his ID. We’ll just want to know what treatment they provided at home and probably the last time she ate or drank (for purposes of surgery that’s important to know.)
2b. Should they call the ER en route?
Jordyn: No, this is cheesy. People do it but it won’t move you up in line, it doesn’t reserve a spot, etc. We’ll say, “Okay, see you when you get here.” Unless they are requesting emergency info—like how to do CPR—it doesn’t make a difference in the care of the patient when they arrive. You'd be surprised how many people call and then never show up.
2c. Is it plausible they're not too busy at 3am on Sunday morning? And go pretty straight back?
Jordyn: Yes, this is plausible.
3. Will the medical staff allow the heroine/medic back into the ER room etc. before dad gets there?
Jordyn: Yes, if she is the only adult and the daughter is comfortable with her, she’d be allowed back.
4. When dad gets there, will they require any ID for him to prove he's dad?
Jordyn: Typically, we get ID and insurance card if they have one. Before that—attempts will be made to reach him via phone to get verbal consent to treat. This is a big deal with minors. If it’s not an emergency—medical treatment can wait. If it is an emergency—we can go ahead and treat regardless on consent. 


When she's not writing about her imaginary friends, Carol Moncado is hanging out with her husband and four kids in the big yard of her southwest Missouri home, teaching American Government at a community college, reading, or watching Castle and NCIS. She's a member of ACFW and RWA, founding member and current facilitator for the MozArks ACFW group, and a category coordinator for ACFW's First Impressions. 

Monday, March 25, 2013

Author Question: Paying Medical Bills

Carrie S. Asks:

My character's ended up in hospital a second time! This time it's not against his will, but the question I have is about paying for his treatment. He's just received treatment for a broken arm, and now he needs to leave. I understand that the hospital would treat him regardless of whether he could pay, but I assume they would also do their best to make sure they were paid if possible.

The situation is this: My character does not have insurance, but he can pay, thanks to a friend. However, he doesn't have any means of payment right now. Nor does he have an address, bank account, or any way for the hospital to make sure he pays up. What would happen? Would they just let him go and hope he was honest enough to come back with the cash?

The hospital in question is non-profit, if that makes a difference.

Jordyn Says:

Wow! Your character is definitely running into some bad luck. 

The hospital would discharge him and hope he pays at some point. If seen in the ED, they may request a copay at the end of his visit (you can't ask for copays until the patient has been seen) but if he doesn't have the money there's not much that can be done at that point. We don't hold people hostage for payment--particularly the nursing staff. It will be the billing department that ultimately follows up.

It really does not make a difference if the hospital is for profit or non profit. Each requires money to keep their doors open. Most hospitals do try to work with individuals and set up payment plans for services rendered.

Sunday, March 24, 2013

Up and Coming

Hello Redwood's Fans!

Are you enjoying spring? This is how we enjoy spring in Colorado. I know . . . you're jealous, right? It is sooo chilly!

Currently, I'm still doing some blog tours for the release of Poison. Here are two opportunities you have to try and win it.

1. Heather Day Gilbert's blog. She's doing an interview and a giveaway that ends March 27th.

2. Elaine Stock's blog Everyone's Story. Here I share a little bit about what keeps me on this crazy writing journey in the absence of a James Patterson type paycheck. Hopefully it will encourage you as well. Drawing ends March 29th.

For you this week! I'm focusing on author questions which is always great fun for me.

Monday: Paying medical bills. I know . . . what joy!

Wednesday: Consent issues in the pediatric ER.

Forensic Friday
: Condition of a body found in water.

I hope you'll tune in for these fabulous posts and drop by those blogs to try to win Poison!

Friday, March 22, 2013

Forensic Friday: What Happened to Kenny? Part 2

In the first part of this series on an actual death investigation, Kenny, a male corpse in various stages of decomposition, was discovered dumped in a wooded area near a Canadian west coast city on a hot summer day.

There was no immediate identification, no apparent time of death, no location where he might have died, and certainly no obvious cause of death. Even without these basics, the corpse and the scene still crawled with information. On the surface, thousands of things were going to help in narrowing down the length of time that Kenny had been there.


Entomology is a long accepted forensic science in determining the progression of nature’s recycling program. It relies on the study of the insect life cycle; egg, larva, pupa, adult, and back to egg. Each species has a specific time frame and a collection of specimens from the scene is critical. By determining which insects were present and what stages of development they were in, you can simply count the days of production. Fortunately, two factors were in favor this day.

One is that the conditions were perfect for insect proliferation; early summer, hot and dry weather, being in a semi-shaded rural area, and having a huge supply of rotting flesh. The second was having a world renowned lady entomologist residing a phone call away at the University of British Columbia – the ‘Bug Bitch’ as she’s affectionately known in the forensic world.

The scene was held until the entomologist arrived and took samples of the insect life and surrounding vegetation. A forensic pathologist was consulted by phone but declined to attend. Contrary to popular police shows, pathologists rarely examine a body on site as there’s little they can do that the coroner and police forensic officers can’t. A common misconception is that time of death can be readily determined by a pathologist taking rectal temperature or pulling some rabbit from their hat. Absolutely not so.

A must-do was a manual search of the corpse for any identifiers; wallet with ID, jewelry, pocket contents – anything – and in Kenny’s case nothing was found. There were some apparent things for follow-up. His mummified left arm showed numerous tattoos and his teeth, very visible in the skeletonized skull, showed a large gap between the top incisors. Without a doubt, in life, Kenny would have been very recognizable when he smiled.

A scene search had been methodically conducted by a small army of police officers and two service dogs. This was done in a strict grid pattern and anything of interest was recorded on a GPS data point, then collected, catalogued as evidence, and mapped out in a computerized reconstruction. This sounds easy, but the thick woods and step terrain made the search a logistical hassle.

Compounding the challenge was that the site had been used as an unauthorized waste dump. For years, careless people had chucked stuff over this bank and it was strewn with plastics and papers, tires and tools, boards and bags and boxes. Determining what was current, what was historic, and what was relevant, was a judgment call however something of interest could be seen trapped under the body.

Remains removal is usually a matter of physically lifting the corpse and placing it in a body bag, then carrying it to a van and transporting to the morgue. In Kenny’s case – not so easy. His state of decomp was to the point of disarticulation; in other words coming apart at the joints. Now this is not the first time a rotting corpse had been transferred and a trick of the trade is to use large, plastic snow scrapers to effectively ‘team shovel’ the cadaver in one piece into a bag. Again, sounds simple, till you consider this was on an incline and the first disturbance caused a swarm flies and a reek of gassing off.

With Kenny now on his way to the morgue, a better look was taken at what had been underneath him. A white plastic bag was recovered which contained the usual garbage; 7-11 wrappers, Big Gulp cups, napkins, pop cans… and a receipt with a time and date.

This obviously had been down the bank before Kenny landed on top of it, but did it come with him? It’d eventually proved corroborative in determining Kenny’s time of death, but who was he? How’d he get here? And what or who the hell killed him?

There was a lot of science ahead. And some good ‘ol detective work.


Garry Rodgers has lived the life that he writes about. Now retired as a Royal Canadian Mounted Police homicide detective and forensic coroner, Garry also served as a sniper with British SAS–trained Emergency Response Teams and is a recognized expert-witness in firearms. A believer in ‘What Goes Around, Comes Around’ Garry provides free services in helping writers through his crime and forensic expertise. Garry’s new supernatural thriller No Witnesses To Nothing is based on a true crime story where many believe that paranormal intervention occurred. An Amazon Top 10 Bestseller, it’s available on Kindle and print on demand. You can connect with Garry via his Website:

Wednesday, March 20, 2013

Lisa's Story: Part 2/2

Today concludes Lisa's story-- a story that likely happens every day-- nurses advocating on behalf of their patients to save their lives.

You can  read Part I here.

Welcome back, Lisa!

I instantly had a suspicion of what I might be dealing with and finally called the pulmonologist. Lucky for me, it was a doctor I was quite familiar with and someone I trusted. He could sense the urgency in my voice, as I relayed the information to him. And he started dictating a number of tests that he wanted done. I had to get firm with him, and finally told him to stop.

“She just returned from India 2 weeks ago, she’s been in and out of 3 hospitals and 4 urgent cares in the last 2 weeks.”

 He stopped dead in his tracks, and said, “Lisa, what do you think this is we are dealing with?”

I was shocked he asked, but I had a gut feeling. “I think she might have malaria.”

His reply was a barrage of orders and ended with a “Holy . . .”
“Wait,” I replied.

He stopped and asked what was wrong. I then relayed that she had taken her 2 year old daughter with her.

Here’s the thing. I had heard about malaria and we had touched on it in nursing school, but I had never seen a case of it, so I had truly no idea if that was right. His mind was racing too. This was South Carolina! We don’t see cases of malaria here. He said I needed to call the hospitalist back and make sure he told the husband to take the little girl to the children’s hospital.

I called the hospitalist back and had to argue with him on the phone. I remember as clear as day telling him that if he didn’t let the man know to get his 2 year old daughter to the hospital, her death would be on his hands not mine. I remember arguing and even cussing at him, I was so angry and he seemed to care about was that I was interrupting his 3 am sleep.

Fast forward . . .

The lady ended up being transferred to the other hospital where in fact the 2 year old had been admitted for also having a case of Malaria. The husband had not traveled with them so luckily he had not contracted it. My patient was transferred to the other hospital on her 30th birthday. What a way to spend your birthday!

In the end, both she and her daughter were treated and were fine. But that story still warms my heart, because of my stubbornness and persistence I truly believe that I was responsible for saving not one but two precious lives.

The following day I was leaving the floor and heading home. For some reason I decided to go through the ICU to take the stairs instead of the elevator.

As I walked past the nursing station, I heard a man’s voice saying, “Are you Lisa?” I stopped to see the face of an unfamiliar doctor. “Yes, I’m Lisa.”

“The same Lisa who called me last night and chewed me a new orifice, and demanded I call Mrs.X’s husband?”

I sheepishly replied, “Uh, yeah, that was me, guilty as charged.” I said holding up my right hand in admission of being the woman who had made his night a living hell.

He bowed and said, “You may have just saved not only 2 lives, but my career.”

He reached over and kissed my hand in a bowed position with one knee on the floor. I was to say the least shocked and embarrassed. The entire ICU staff started smiling at me. I left with the biggest smile on my face and my heart filled with joy.

Those are the moments that make nursing truly worthwhile.

Shortly after this happened, have you traveled outside of the country was added to the admission forms.

Here is a link to Malaria and its signs and symptoms:


Lisa was born Lise Amanda Forest on November 19, 1966 in Ontario. She has 2 children, and 1 grandchild. She currently, lives in SC. Lisa speaks French and English. She graduated from College and worked as a flight attendant for a Montreal based airline. Lisa is a world traveler, having been to South America, Caribbean, and all over Europe; Lisa has been employed as an RN for the last 18 years. Lisa has moonlighted as a realtor and interior designer. Now she’s a writer and her debut novel Oracle is in editing. You can visit Lisa at her blog

Monday, March 18, 2013

Lisa's Story: Part 1/2

I wanted to share this story of a fellow comrade in arms-- a nurse working in the trenches that likely, only through her efforts, did a patient not succumb to death.

There is so much of nursing that goes unnoticed. What nurses do every day. The battles we fight on behalf of patients and their families that likely are never known by those we care for.

I also like first person accounts because they allow writers to "live in someone else's shoes" for a moment and might make writing from that person's position much more authentic.

Part I will be today and Part II will conclude on Wednesday.

Welcome, Lisa!

I am so happy to share this story, as this is one of my favorite moments as a nurse.

I typically worked the Baylor shift of 7pm to 7am at one of the local hospitals. Even though the story I am telling you happened about 7 years ago some of the details are still so very fresh in my mind. I have always believed there are no such things as coincidences. And this story truly emphasizes that.

I had arrived to the floor, received my change of shift report and was settling in for the night.

Shortly, thereafter we got a call that a young 29 year old woman was being admitted to the floor. I had no empty beds and my co-worker was a male nurse. This young woman was brought up to the floor with an admitting diagnosis of urinary tract infection and possible respiratory alkalosis.

Immediately, the diagnosis just seemed off to me. When the woman arrived I also noticed she was from India, she felt very uncomfortable with the male nurse so I asked him to switch off with me and I would take the admission. I really didn’t understand why she was being admitted to my floor. We were the IICU, intermediate intensive care unit. We essentially took the overflow from the ICU, with the only exception that we didn’t taker arterial lines. We did everything else, from vents, to trach’s, to PICC lines, and countless drips, and we rarely got anyone under the age of 50.

At first glance the woman really didn’t seem that ill. I was rather confused by her admission to my unit. After a few questions, I returned to enter her information into the computer system. I had barely sat down and the bell was ringing. I got up and headed towards the room. I had never seen anything like it. She was ashen, diaphoretic, and trying to make her way to the bathroom due to nausea. As I reached over to help her up she felt like she was on fire. I told her to sit still. I had just checked her temperature not 15 minutes prior and it had been slightly elevated around 99.8. But this time when I checked it, it was over 103. I was shocked and terrified for this poor woman.

I helped her up to the bathroom and helped her get changed and settled her back into bed. I took a look at all the new orders, returned with some Tylenol for her and began looking at the history. Something in my gut was telling me we were missing something. I read and reread her admission paperwork trying to find a clue. I called the hospitalist on call and related my story. He essentially blew me off and said I needed to contact the pulmonologist. Before I had a chance to call, she was ringing the bell again, and this time she looked even worse. Her body was writhing all over the bed, almost convulsing and she had no control over it. I looked at her and asked a simple question.

“Have you traveled outside of the country in the last few months?”

Her reply was “yes”, she and her daughter had just returned from India 2 weeks prior.

 I looked at her, and asked, “How old is your daughter?”

The reply, “She is only 2 years old.” 

Hope you'll join us for Part II on Wednesday to see what this patients mysterious illness is. What might your guess be?


Lisa was born Lise Amanda Forest on November 19, 1966 in Ontario. She has 2 children, and 1 grandchild. She currently, lives in SC. Lisa speaks French and English. She graduated from College and worked as a flight attendant for a Montreal based airline. Lisa is a world traveler, having been to South America, Caribbean, and all over Europe; Lisa has been employed as an RN for the last 18 years. Lisa has moonlighted as a realtor and interior designer. Now she’s a writer and her debut novel Oracle is in editing. You can visit Lisa at her blog